Study of cardiac pathology in young adults- an autopsy based prospective study

Cardiovascular disease is now the most common cause of death worldwide. The sudden death in apparently healthy young individuals is always a devastating and shocking event. Now because of change in lifestyle and habits, many cardiac pathologies are noticed in comparatively younger age group even in a developing country like India and some of these cardiac pathologies are inheritable. Hence an autopsy based prospective study was conducted at the department of Forensic Medicine, Victoria Hospital, Bangalore Medical College & Research Institute, Bangalore, over a period of 18 months from November 2013 to May 2015, in young adults aged between 18 to 40 years dying due to various reasons like road traffic accidents, poisoning, burns, hanging, sudden natural deaths, assaults, electrocution, snake bite etc, and autopsy findings of total 200 cases subjected for medicolegal autopsy were studied, to know the incidence of various underlying cardiac pathologies in young adults and their epidemiological aspects so that we can counsel the close family members of the deceased to go through essential investigations and take preventive measures in case of inheritable cardiac pathologies. Out of 200 cases, 51 (25.5%) were found to be normal. Out of which 34 were males and 17 were females, majority 27 (52.9%) were in the age group of 18-25 years. While majority of cases 143 (71.5%) cases showed underlying Atherosclerotic Coronary Artery Disease which also included fixed coronary obstruction, thrombus, recent and healed Myocardial Infarction. Out of that, 117 (81.8%) were males and 26 (18.2%) were females. Majority of cases of Atherosclerotic coronary artery disease were in the age group 26-33 years which include 50 (35%) males and 10 (7%) females. Other significant underlying cardiac pathologies were Pericarditis 7 (3.5%), Valvular heart disease including Rheumatic heart disease 7 (3.5%), Arrhythmogenic Right Ventricular Dysplasia 2 (1%), Myocarditis 4 (2%), Concentric Left ventricular hypertrophy 4 (2%), Biventricular hypertrophy 4 (2%), Cardiac Polyp 2 (1%), Anomalous/Aberrant Coronary artery 2 (1%), Hypertrophic cardiomyopathy 1 (0.5%), Dilated cardiomyopathy 1 (0.5%), Pancarditis 1 (0.5%) and Coronary artery Vasculitis 1 (0.5%).
Atherosclerotic coronary artery disease was the most frequently encountered underlying cardiac pathology even in young adults. Finding 1% cases of arrhythmogenic right ventricular dysplasia (ARVD), in a country like India is very significant and is a matter of concern.